National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (6)
- Cancer (3)
- Cancer: Colorectal Cancer (2)
- Cancer: Lung Cancer (2)
- Cardiovascular Conditions (3)
- Children/Adolescents (1)
- Comparative Effectiveness (2)
- Dialysis (1)
- Disparities (1)
- Elderly (8)
- Evidence-Based Practice (1)
- Healthcare Cost and Utilization Project (HCUP) (3)
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- Healthcare Utilization (1)
- Heart Disease and Health (2)
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- (-) Mortality (21)
- Neurological Disorders (1)
- Outcomes (9)
- Patient-Centered Outcomes Research (6)
- Patient Safety (4)
- Provider Performance (1)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Risk (3)
- (-) Surgery (21)
- Teams (1)
- Transitions of Care (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedOnaitis MW, Furnary AP, Kosinski AS
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
This study compared the effectiveness of lobectomy and segmentectomy for treatment of clinical stage IA (T1N0) lung cancer patients. The Society of Thoracic Surgeons General Thoracic Surgery Database was linked to Medicare data in 14,286 lung cancer patients who underwent segmentectomy (n = 1654) or lobectomy (n = 12,632) from 2002 to 2015. Survival rates were found to be similar.
AHRQ-funded; HS022279.
Citation: Onaitis MW, Furnary AP, Kosinski AS .
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
Ann Thorac Surg 2020 Dec;110(6):1882-91. doi: 10.1016/j.athoracsur.2020.01.020..
Keywords: Cancer: Lung Cancer, Cancer, Surgery, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Philip JL, Yang DY, Wang X
Effect of transfer status on outcomes of emergency general surgery patients.
This study looked at outcomes of transferred (TRAN) versus directly admitted (DA) emergency general surgery (EGS) patients. Patients with a diagnosis of EGS were identified from the 2008-2011 Nationwide Inpatient Sample (NIS). Outcomes included were in-hospital mortality and morbidity. They identified 274,145 TRAN and 10,456,100 DA encounters. Morbidity and mortality were both higher in TRAN patients than DA. TRAN patients were more likely to have greater comorbidity scores, have Medicare insurance, and reside in an area with a lesser median household income compared to DA patients. Morbidity among TRAN patients were primarily due urinary-, gastrointestinal-, and pulmonary-related complications. Median stay and median cost at the hospital were greater for TRAN patients.
AHRQ-funded; HS025224; HS022694.
Citation: Philip JL, Yang DY, Wang X .
Effect of transfer status on outcomes of emergency general surgery patients.
Surgery 2020 Aug;168(2):280-86. doi: 10.1016/j.surg.2020.01.005..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Transitions of Care, Mortality, Outcomes, Healthcare Costs, Hospitals
McIsaac DI, Taljaard M, Bryson GL
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
The purpose of this study was to compare the accuracy of the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS) to predict death or patient-reported new disability 90 days after major elective surgery. Results showed that older people with frailty are significantly more likely to die or experience a new patient-reported disability after surgery and that although accuracy was similar, the CFS, compared to the mFI, was easier to use and feasibility was higher.
AHRQ-funded; HS023313.
Citation: McIsaac DI, Taljaard M, Bryson GL .
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
Ann Surg 2020 Feb;271(2):283-89. doi: 10.1097/sla.0000000000002967..
Keywords: Elderly, Patient-Centered Outcomes Research, Surgery, Mortality, Adverse Events, Risk, Outcomes
Dworsky JQ, Childers CP, Gornbein J
Hospital experience predicts outcomes after high-risk geriatric surgery.
This study examined if there an association between a hospital’s annual volume of high-risk geriatric surgery and their risk of inpatient mortality, postoperative length of stay, and discharge to nursing facility. Using the 2014 National Inpatient Sample, older adults were identified who had undergone high-risk geriatric surgery. There were an estimated 514,950 hospital encounters at 3,115 hospitals undergoing surgery. A higher proportion of high-risk geriatric surgery patients was associated with decreased mortality and shorter postoperative length of stay. Higher volume hospitals were not associated with mortality but was associated with longer length of stay and decreased discharge to nursing facilities.
AHRQ-funded; HS000046; HS025079.
Citation: Dworsky JQ, Childers CP, Gornbein J .
Hospital experience predicts outcomes after high-risk geriatric surgery.
Surgery 2020 Feb;167(2):468-74. doi: 10.1016/j.surg.2019.07.026..
Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Surgery, Risk, Hospitals, Outcomes, Mortality
Vemana G, Kim EH, Bhayani SB
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
The researchers sought to determine survival differences among patients receiving endoscopic vs surgical management for upper tract urothelial carcinoma (UTUC). They found that although initial survival outcomes are similar for endoscopic and surgical management of nonmuscle-invasive, low-grade UTUC, both cancer-specific survival and overall survival are significantly inferior for the endoscopic management group in the longer term. They also found that transition from initial endoscopic management to surgical intervention appears to have limited impact on survival.
AHRQ-funded; HS019455.
Citation: Vemana G, Kim EH, Bhayani SB .
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
Urology 2016 Sep;95:115-20. doi: 10.1016/j.urology.2016.05.033.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Mortality, Surgery
Wong SL, Revels SL, Yin H
Variation in hospital mortality rates with inpatient cancer surgery.
The purpose of this national study was to elucidate clinical mechanisms underlying variation in hospital mortality with major cancer surgery. It found that case-fatality rates among patients with complications at high-mortality hospitals were approximately twice as high as at low-mortality hospitals. This study implicates failure to rescue as the major reason for differences in hospital mortality rates with major cancer surgery.
AHRQ-funded; HS020937.
Citation: Wong SL, Revels SL, Yin H .
Variation in hospital mortality rates with inpatient cancer surgery.
Ann Surg 2015 Apr;261(4):632-6. doi: 10.1097/sla.0000000000000690..
Keywords: Mortality, Surgery, Cancer, Patient Safety, Quality of Care
Healy MA, Grenda TR, Suwanabol PA
Colon cancer operations at high- and low-mortality hospitals.
The authors sought to evaluate causes of mortality following colon cancer operations across hospitals. They found significant variation in mortality across hospitals for colon cancer operations, reflecting a need for improved operative decision-making to enhance outcomes and quality of care.
AHRQ-funded; HS020937; HS023621; HS000053.
Citation: Healy MA, Grenda TR, Suwanabol PA .
Colon cancer operations at high- and low-mortality hospitals.
Surgery 2016 Aug;160(2):359-65. doi: 10.1016/j.surg.2016.04.035.
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Keywords: Adverse Events, Cancer: Colorectal Cancer, Mortality, Patient Safety, Surgery
Mehta HB, Parmar AD, Adhikari D
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
This study's objective was to evaluate the relative effects of surgeon and hospital volume on mortality and complications after pancreatic resection among older patients. The researchers used Texas Medicare data and found that high surgeon volume and high hospital volume were associated with lower risk of mortality, while high surgeon volume was also associated with lower risk of complications.
AHRQ-funded; HS022134.
Citation: Mehta HB, Parmar AD, Adhikari D .
Relative impact of surgeon and hospital volume on operative mortality and complications following pancreatic resection in Medicare patients.
J Surg Res 2016 Aug;204(2):326-34. doi: 10.1016/j.jss.2016.05.008.
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Keywords: Adverse Events, Elderly, Hospitals, Mortality, Surgery
Fernandez FG, Furnary AP, Kosinski AS
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
The purpose of this paper was to provide longitudinal follow-up to the Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) through linkage to the Centers for Medicare and Medicaid Services (CMS) data for patients 65 years of age or older. The researchers found that median survival after lung cancer resection was 6.7 years for pathologic stage I, 3.5 years for stage II, 2.4 years for stage III, and 2.2 years for stage IV. They concluded that CMS data complement the STS GTSD data by enabling examination of long-term survival and resource utilization in patients 65 years or older.
AHRQ-funded; HS022279.
Citation: Fernandez FG, Furnary AP, Kosinski AS .
Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older.
Ann Thorac Surg 2016 Jun;101(6):2067-76. doi: 10.1016/j.athoracsur.2016.03.034.
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Keywords: Cancer: Lung Cancer, Surgery, Elderly, Outcomes, Mortality
Jenkins KJ, Koch Kupiec J, Owens PL
AHRQ Author: Owens PL
Development and validation of an Agency for Healthcare Research and Quality indicator for mortality after congenital heart surgery harmonized with risk adjustment for congenital heart surgery (RACHS-1) methodology.
The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by AHRQ. Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies.
AHRQ-authored.
Citation: Jenkins KJ, Koch Kupiec J, Owens PL .
Development and validation of an Agency for Healthcare Research and Quality indicator for mortality after congenital heart surgery harmonized with risk adjustment for congenital heart surgery (RACHS-1) methodology.
J Am Heart Assoc 2016 May;5(5):pii: e003028. doi: 10.1161/jaha.115.003028.
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Keywords: Surgery, Mortality, Quality Indicators (QIs), Children/Adolescents, Cardiovascular Conditions
Sheetz KH, Dimick JB, Ghaferi AA
Impact of hospital characteristics on failure to rescue following major surgery.
This study determined the effect of hospital characteristics on failure to rescue after high-risk surgery in Medicare beneficiaries. It found that although several hospital characteristics are associated with lower failure to rescue rates, these macrosystem factors explain a small proportion of the variability between hospitals. This suggests that microsystem characteristics may play a larger role in improving a hospital's ability to manage postoperative complications.
AHRQ-funded; HS023621.
Citation: Sheetz KH, Dimick JB, Ghaferi AA .
Impact of hospital characteristics on failure to rescue following major surgery.
Ann Surg 2016 Apr;263(4):692-7. doi: 10.1097/sla.0000000000001414.
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Keywords: Surgery, Elderly, Adverse Events, Disparities, Mortality
Brown JR, Rezaee ME, Nichols EL
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
This study examined cardiac catheterization or percutaneous coronary intervention (PCI) hospital discharges from the nationally representative National Inpatient Sample to determine annual population incidence rates for AKI and AKI-D in the United States from 2001 to 2011. It found that the incidence of AKI among cardiac catheterization and PCI patients has increased sharply in the United States; however, mortality has significantly declined.
AHRQ-funded; HS018443.
Citation: Brown JR, Rezaee ME, Nichols EL .
Incidence and in-hospital mortality of acute kidney injury (AKI) and dialysis-requiring AKI (AKI-D) after cardiac catheterization in the National Inpatient Sample.
J Am Heart Assoc 2016 Mar 15;5(3):e002739. doi: 10.1161/jaha.115.002739.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Events, Mortality, Patient Safety, Surgery, Heart Disease and Health, Cardiovascular Conditions, Kidney Disease and Health, Dialysis, Hospitals
Wancata LM, Banerjee M, Muenz DG
Conditional survival in advanced colorectal cancer and surgery.
The authors evaluated the impact of cancer-directed surgery on long-term survival in patients with advanced colorectal cancer (CRC). They found that five-year disease-specific conditional survival improves dramatically over time for selected patients with advanced CRC who undergo cancer-directed surgery.
AHRQ-funded; HS020937.
Citation: Wancata LM, Banerjee M, Muenz DG .
Conditional survival in advanced colorectal cancer and surgery.
J Surg Res 2016 Mar;201(1):196-201. doi: 10.1016/j.jss.2015.10.021.
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Keywords: Cancer: Colorectal Cancer, Mortality, Outcomes, Patient-Centered Outcomes Research, Surgery
Hollis RH, Singletary BA, McMurtrie JT
Blood transfusion and 30-day mortality in patients with coronary artery disease and anemia following noncardiac surgery.
The researchers evaluated the association between postoperative blood transfusion and mortality in patients with coronary artery disease and postoperative MI following noncardiac surgery. Their findings support a restrictive postoperative transfusion strategy in patients with stable coronary artery disease following noncardiac surgery.
AHRQ-funded; HS013852.
Citation: Hollis RH, Singletary BA, McMurtrie JT .
Blood transfusion and 30-day mortality in patients with coronary artery disease and anemia following noncardiac surgery.
JAMA Surg 2016 Feb;151(2):139-45. doi: 10.1001/jamasurg.2015.3420.
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Keywords: Mortality, Surgery, Heart Disease and Health, Patient-Centered Outcomes Research
Schlitz NK, Kaiboriboon K, Koroukian SM
Long-term reduction of health care costs and utilization after epilepsy surgery.
This study assessed long-term direct medical costs, health care utilization, and mortality following resective surgery in persons with uncontrolled epilepsy. It found that the mean direct medical cost difference between the surgical group and control group was $6,806 after risk-set matching. The incidence rate ratio of inpatient, emergency room, and outpatient utilization was lower among the surgical group in both unadjusted and adjusted analyses.
AHRQ-funded; HS000059.
Citation: Schlitz NK, Kaiboriboon K, Koroukian SM .
Long-term reduction of health care costs and utilization after epilepsy surgery.
Epilepsia 2016 Feb;57(2):316-24. doi: 10.1111/epi.13280.
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Keywords: Healthcare Costs, Healthcare Utilization, Mortality, Neurological Disorders, Outcomes, Surgery
Tamirisa NP, Parmar AD, Vargas GM
Relative contributions of complications and failure to rescue on mortality in older patients undergoing pancreatectomy.
This study evaluated the relative contribution of overall postoperative complications and failure to rescue rates on the observed increased mortality in older patients undergoing pancreatic resection at specialized centers. In experienced hands, the rates of complications after pancreatectomy in patients 80 years or older compared to patients younger than 80 years were similar. However, when complications occurred, older patients were more likely to die.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Parmar AD, Vargas GM .
Relative contributions of complications and failure to rescue on mortality in older patients undergoing pancreatectomy.
Ann Surg 2016 Feb;263(2):385-91. doi: 10.1097/sla.0000000000001093..
Keywords: Elderly, Mortality, Surgery, Adverse Events, Patient-Centered Outcomes Research
Ghaferi AA, Dimick JB
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
The researchers reviewed the literature evaluating surgery, mortality, failure-to-rescue and the elderly. This was followed by a review of ongoing studies and unpublished work aiming to understand better the mechanisms underlying variations in surgical mortality in elderly patients. They concluded that although elderly surgical patients experienced failure-to-rescue events at much higher rates than their younger counterparts, patient-level effects did not sufficiently explain these differences.
AHRQ-funded; HS023621; HS024403; HS023597.
Citation: Ghaferi AA, Dimick JB .
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
Br J Surg 2016 Jan;103(2):e47-51. doi: 10.1002/bjs.10031.
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Keywords: Elderly, Mortality, Surgery, Teams, Patient Safety
Du DT, McKean SJ, Kelman JA, et al.
AHRQ Author: Encinosa W
Early mortality after aortic valve replacement with mechanical prosthetic vs bioprosthetic valves among Medicare beneficiaries: a population-based cohort study.
The researchers compared early mortality after aortic valve replacement (AVR) between the recipients of mechanical and bioprosthetic aortic valves. Among 66,453 Medicare beneficiaries who received AVRs, use of mechanical valves was associated with a higher risk for death on the date of surgery and within 30 days compared with the bioprosthetic aortic valves. However, this applied only to those who underwent concurrent AVR and coronary artery bypass graft but not isolated AVR.
AHRQ-authored
Citation: Du DT, McKean SJ, Kelman JA, et al..
Early mortality after aortic valve replacement with mechanical prosthetic vs bioprosthetic valves among Medicare beneficiaries: a population-based cohort study.
JAMA Intern Med. 2014 Nov;174(11):1788-95. doi: 10.1001/jamainternmed.2014.4300..
Keywords: Cardiovascular Conditions, Medicare, Mortality, Patient-Centered Outcomes Research, Surgery
Huesch MD
The impact of short breaks from cardiac surgery on mortality and stay length in California.
In this small, exploratory study, the researchers sought to investigate potential surgical “forgetting” among cardiac surgeons taking a break from performing isolated coronary artery bypass graft (CABG) surgery in a large state-wide study in California. Patients operated on by surgeons who had not performed isolated CABG in the prior calendar month stayed in hospital 0.5 day longer.
AHRQ-funded; HS021868.
Citation: Huesch MD .
The impact of short breaks from cardiac surgery on mortality and stay length in California.
J Healthc Qual 2014 Sep-Oct;36(5):42-9. doi: 10.1111/jhq.12018..
Keywords: Surgery, Outcomes, Mortality, Risk
Hockenberry JM, Helmchen LA
The nature of surgeon human capital depreciation.
The authors estimated how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). They found that a surgeon's additional day away from the operating room raised patients' inpatient mortality by up to 0.067 percentage points but reduced total hospitalization costs by up to 0.59 percentage points, and among emergent patients treated by high-volume providers, an additional day away raised mortality risk by 0.398 percentage points but reduced cost by up to 1.4 percentage points. They concluded that their results are consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications.
AHRQ-funded; HS019743.
Citation: Hockenberry JM, Helmchen LA .
The nature of surgeon human capital depreciation.
J Health Econ 2014 Sep;37:70-80. doi: 10.1016/j.jhealeco.2014.06.001.
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Keywords: Healthcare Costs, Mortality, Provider Performance, Surgery
Jones WS, Dolor RJ, Hasselblad V
Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia.
This systematic review found that there is no difference in clinical outcomes for patients with critical limb ischemia treated with endovascular or surgical revascularization. This review of 23 studies found no differences in overall death, amputation, or amputation-free survival at 2 or more years following treatment.
AHRQ-funded; 290200710066I
Citation: Jones WS, Dolor RJ, Hasselblad V .
Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia.
Am Heart J. 2014 Apr;167(4):489-498.e7. doi: 10.1016/j.ahj.2013.12.012..
Keywords: Comparative Effectiveness, Outcomes, Surgery, Mortality